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President Barack Obama ruled out "safe zones" in rebel-held areas of Syria on Monday as attempts to prevent a bloodbath in Aleppo were deadlocked.

Mr Obama appeared to contradict his own officials and confirm allegations of confusion in US policy as he over-ruled suggestions from his own officials that special safe zones for “moderate” rebels might be set up in the city.

Aleppo has been bombarded from the air in recent days despite a supposed ceasefire, with Assad regime troops said to be massing for an all-out assault.

The regime says it is attacking Jabhat al-Nusra, the al-Qaeda offshoot which is in alliance with some of the rebel groups operating in the city.

The “safe zone” plan which surfaced in briefings on Sunday would have allowed the US to back the rebels without appearing to side with al-Qaeda. But a day later Mr Obama ruled it out.

He believed it was not a “practical alternative” for Syria, his spokesman, Josh Earnest, said.

He described the “out of control” violence in Aleppo as “deeply disturbing, to everyone in the world” and warned it could not be allowed to continued unabated.

On Sunday night, the main, and only, road out for those in rebel-held east was bombed. The opposition has warned if the regime manages to close off the route, its nearly 200,000 residents would be left trapped and cut off from food and medical supplies.

And while there was relative calm on Monday morning as officials sat around the negotiating table, an ambulance and its crew trying to reach people injured in the weekend’s attacks was hit in Aleppo’s Halak neighbourhood.

At least 253 civilians - including 49 children - have been killed on both sides of the city since April 22, the UK-based Syrian Observatory for Human Rights monitor reported. Rebels have responded to regime air attacks with shelling of the regime-held west of the city.

Ismail al-Abdullah, an activist living in Aleppo, told the Telegraph it was likely that President Bashar al-Assad’s forces would retake the main Castello road in the coming days.

“Time is running out for people here,” he warned. “People are just sitting and waiting to see what is decided in Geneva, hoping that something will save them.

“I just hope the revolution doesn’t end how it started - with America sitting on its hands.”

Khalid Kanjo, leader of the First Brigade, which operates under the US-backed Free Syrian Army banner and has nearly 1,500 fighters in Aleppo, told the Telegraph: “Even if there is a truce we will not return to Geneva, all the Russians and Assad want is war. If they wanted a political solution they would at least let the aid reach besieged parts of the city.”

A Red Crescent aid worker inspects scattered medical supplies after an airstrike on a medical depot in the rebel-held Tariq al-Bab neighbourhood of Aleppo, SyriaCredit:
REUTERS

The fighting has drawn in global powers and regional states after all political efforts to resolve it foundered over the fate of President Assad, who refuses to accept opposition demands that he leave power.

Diplomatic pressure has been mounting, particularly from the United Nations, which has said it was a matter of urgency for an agreement to be reached to end the “monstrous” bloodshed of the last 10 days.

While ceasefires were yesterday extended in other parts of the country, the US has so far failed to push Russia to rein in its ally’s forces in Aleppo, which has seen the worst of the violence.

One of Assad’s key goals is to retake the city, for which preparations have been underway for months.

If Assad was able to “liberate” the strategic city it would boost not only the Syrian government’s popular legitimacy but the president’s too.

Analysts predicted it was unlikely the government and its Russian backers would agree to a full ceasefire without conditions in Aleppo as it would give the rebel side the chance to strengthen its position.